Smoking cessation Felix K. Karthik

Why smoking is addictive? Positive reinforcment Increase in dopamine Binds to nACh receptors NICOTINE

Tobacco Withdrawal symptoms

SMOKERS DIE EARLY! Pirie et al Lancet. 2013 Jan 12;381(9861):133-41

Making a quit attempt Tensions and triggers Tension Triggers Price Health concerns Triggers Sudden illness Price rise Advice from a health professional

Remaining quit

Importance of brief advice Stead et al 2013. Physician advice for smoking cessation. Cochrane Database of Systematic Reviews. CD: 000165

Getting over the initial withdrawal discomfort Behavioural support is of proven efficacy Can be delivered in different formats Face-to-face (individual or group) Telephone Internet Pharma intervention: NRT (nicotine replacement therapy), bupropion (Zyban), nortriptyline and varenicline (Chantix) are of proven efficacy

Nicotine Delivery

Bupropion

Varenicline (CHANTIX) Varenicline works by reducing craving for cigarettes making quitting smoking a little easier and increases the chances of stopping for good. However it’s no magic cure and effort is still required.

SAFETY AND SIDE EFFECTS -CHANTIX Nausea (30%) – mostly well tolerated Strange dreams, headache, flatulence, and insomnia Serious mood and cardiovascular adverse events

E-Cigarettes How many have tried E-cigarettes?

Components of E-cigarettes

Fluid contains…..

“Harmless” Vapor

Recent FDA measures Push tobacco industry to make cigarettes with less nicotine to make them less addictive Banning sales of e –cigarettes to kids age <18 years FDA carefully weighing still the opportunity for e-cigarettes as potentially low risk alternative to smokers All e-cigarettes including the components of e-cigarettes will be regulated by FDA in the coming years to make it safe!

Finally…… GOOD LUCK! THANK YOU!!!!!